The purpose of this workshop is to define the current knowledge of low back pain and its pathophysiology specific case examples will be used to address clinical and epidemiological aspects of changes within these diagnostic groups with particular attention focused on the clinical problem of the associated pain and the treatment thereof, as it relates to the intervertebral disc, ligaments, nerves and bone: The role(s) of various neurogenic (substance P, CGRP, VIP, etc.) and non neurogenic mediators (prostaglandins, histamines, bradykinin, leukotrienes, etc.) and the induction of inflammatory episodes associated with low back pain and its repair mechanisms, if any, will be addressed. Validation of various animal and clinical models for the diagnosis and treatment of this mostly costly problem will be explored. The overall objective of this workshop is to increase the interdisciplinary exchange of novel ideas among orthopaedic surgeons, neurosurgeons, rheumatologists, epidemiologists, pathologists, bioengineers, cell biologists, biochemists, neurophysiologists, chiropractors and other basic scientists and to provide a forum for the evaluation and interpretation of the most recent research advances in this field. This workshop will define significant advances in the understanding of the etiopathogenesis of low back pain and identify future research directions. Likewise, this workshop will advance understanding and improve prevention and treatment of the second most prevalent and costly disorder, back pain, affecting the U.S. population. Working sessions of the meeting will include presentations by a select group of invited participants of previously submitted manuscripts combined with in depth discussions. These will be followed by breakout groups in which areas of critical concern (definition of gaps Ln knowledge and future research directions) wall be defined. As an additional stimulus to future research, a publication in the Spine journal summarizing the current state of knowledge and avenues for future investigations also-planned. In addition, a full length book containing the submitted and edited manuscripts together with the pertinent contributions during the breakout discussion is also planned. In addition, practical clinical questions, regarding diagnostic categories and treatments that a physician might be asked by a lay Person will be addressed and published. This summary of the proceedings and recommendations will be presented to NIAMS. This workshop represents a continuum of a format established jointly by the NIH and AAOS to address critical areas of concern in musculoskeletal disease.